Long-Term Outcome After Silicone Oil Removal in Eyes with Myopic Retinal Detachment Associated with Macular Hole

Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Mohamed Shebl,4 Mohamed Ahmed Abdelhafez,4 Haithem Maamoun Abdelfattah4,5 1Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Magrabi Eye Hospital, Tanta, Egypt; 3Retina Department, Research Institute of Ophthalmology, Giza, Egypt; 4Vitreoretinal Consultant, Magrabi Eye Hospital, Tanta, Egypt; 5Vitreoretinal Associate Consultant, Benha Teaching Hospital, Benha, EgyptCorrespondence: Mahmoud LeilaRetina Department, Research Institute of Ophthalmology, Giza, EgyptTel +201286644025Email mahmoudleila@yahoo.comPurpose: To assess the efficacy of pars plana vitrectomy (PPV) and silicone oil tamponade for management of myopic retinal detachment associated with macular hole (MRDMH) and to assess the anatomical and functional outcomes of this technique and its long-term validity after silicone oil removal.Methods: Retrospective interventional non-comparative case series including consecutive patients who had PPV and silicone oil tamponade for MRDMH. All patients had an axial length ≥ 26 mm. Main outcome measures were retinal re-attachment and macular hole closure after silicone oil removal, improvement of best-corrected visual acuity (BCVA), and complications secondary to surgery. Chi square/Fisher’s exact test was used to analyze categorical variables, while One-way ANOVA/Kruskal–Wallis test was used to compare variables across the closure type and complications. Correlations between numerical variables were tested using Spearman correlation. Kaplan–Meier method was used to estimate the event-free survival. P value is significant at 0.05.Results: The study included 26 eyes of 26 patients. Retinal re-attachment rate after primary and secondary surgeries was 88.4% and 100%, respectively. W-type macular hole closure occurred in 58% of eyes. Vision improved in 58% of eyes. Mean final BCVA was 0.05 decimal units, p = 0.004. Cataract and glaucoma developed in 42% and 15% of eyes, respectively. Initial BCVA, axial length and duration of silicone oil tamponade did not correlate significantly with either the type of macular hole closure or the final BCVA.Conclusion: PPV and silicone oil tamponade technique promotes successful anatomical and functional outcome in MRDMH. Long-term success is maintained after silicone oil removal. High incidence of silicone oil-induced complications mandate its removal from eyes with successful retinal re-attachment.Keywords: retinal detachment in high myopia, myopic macular hole, retinal detachment secondary to myopic macular hole, PPV for myopic retinal detachment associated with macular hole